Implications of Persistent HPV52 and HPV58 Positivity for the Management of Cervical Lesions

Abstract

ObjectiveThis study aimed to compare the variability of HPV16/18/52/58 subtype infections in patients with different cervical lesions, to explore the guiding significance of persistent positive HPV subtypes 52 and 58 in the stratified management of cervical lesions, and to determine the appropriate management model.MethodThis study was conducted through a retrospective analysis of 244,218 patients who underwent HPV testing at the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University from September 2014 to December 2020 to examine the distribution of different types of HPV infection. From March 2015 to September 2017, 3,014 patients with known HPV underwent colposcopy to analyze high-risk HPV infection for different cervical lesions. Meanwhile, from September 2014 to December 2020, 1,616 patients positive for HPV16/18/52/58 alone with normal TCT who underwent colposcopy in our hospital were retrospectively analyzed for the occurrence of cervical and vulvovaginal lesions, with colposcopic biopsy pathology results serving as the gold standard for statistical analysis.ResultAnalysis of 244,218 patients who had HPV tested revealed that the top 3 high-risk HPV types were HPV52, HPV58, and HPV16. Further analysis of 3,014 patients showed that 78.04% of patients referred for colposcopy had HPV16/18/52/58 alone. Among high-grade squamous intraepithelial lesions (HSIL) and cervical cancer, the most common is HPV16, followed by HPV58 and then HPV52 (p < 0.05). A total of 1,616 patients with normal TCT who were referred for colposcopy due to HPV16/18/52/58 infection were further analyzed. Based on pathological findings in lesions of HSIL and CC, HPV16 is the most common, followed by HPV58 and then HPV18 (p < 0.05). In the 1,616 patients analyzed, high-grade vulvovaginal lesions were detected, with HPV58 being the most common, followed by HPV16 and then HPV52 (p < 0.05).Conclusion1. In patients with positive HPV58 alone and normal TCT, the indications for colposcopy may be relaxed, with particular attention paid to the possibility of vulvar and vaginal lesions.2. Patients with a positive HPV type 52 alone and normal TCT may be considered for a follow-up review and, if necessary, a colposcopy.3. The development of a more suitable HPV vaccine for the Asian population, such as HPV16/18/52/58, may better protect women’s health.

High-Risk Genotypes of Human Papillomavirus at Diverse Anogenital Sites among Chinese Women: Infection Features and Potential Correlation with Cervical Intraepithelial Neoplasia

“…Our results demonstrated that the co-testing of cervical HPV 33/35/52/53/56/58 with HPV 16/18 had better AUC values compared to the clinically well-recognized cervical HPV 16/18 detection. At present, five types of HPV vaccines have been approved: HPV-2 (16, 18) from three different manufacturers, HPV-4 (6,11,16,18), and HPV-9 (6,11,16,18,31,33,45,52,58) [74]. Our results also highlighted the significance of HPV 35/53/56 in cervical lesions, although their association with highgrade lesions is not as clear as that of HPV 16/18/52/58.…”

“…Although HPV 18 has been considered an important HR-HPV in cervical cancer, the prevalence of HPV 18 infection was relatively low in our study population. Several studies reported that the most common HR-HPV subtypes were HPV 52, 58, and 16 for Chinese women, in which HPV 18 was not included [ 56 , 57 , 58 , 59 , 60 , 61 , 62 ]. In addition to HPV 16, 52, and 58, HPV 53, 51, and 56 were proposed as predominant subtypes of HR-HPVs in Chinese women, because of their relatively high prevalence at all testing sites, among which HPV 53 has been highlighted by other studies on the co-infection status in Chinese women [ 63 ].…”

“…More than 95% of cervical cancer cases are attributed to persistent HPV infection [2]. To date, 15 high-risk (HR) HPV subtypes have been identified [3], among which infections to HPV 16,18,31,33,35,39,45,51,52,56,58,59,68,73, and 82 contribute to 96.6% of invasive cervical cancers [4]. In addition to the cervix, other areas of the female genital tract (e.g., the vagina, vulva, and perineum) and anogenital mucosae could also be infected by 40 HPV subtypes [5].…”

Epidemiologic characteristics of high-risk HPV and the correlation between multiple infections and cervical lesions

“…The most common HPV type in women with HSIL was HPV-16, followed by HPV-52, HPV-58, and HPV-33. A study revealed that the most common HPV types are HPV-16 and HPV-58 among women with HSIL and cervical cancer [ 30 ]. Another study showed that persistent HPV-16 and HPV-58 infections are risk factors for cervical disease progression in Korea [ 31 ].…”

The Effect of Cervical Cold-Knife Conization (CKC) on HPV Infection in Patients with High-Grade Cervical Intraepithelial Neoplasia: A Retrospective Study

“…Some scholars have suggested that for patients with HPV58 positive, Colposcopy examination should be more frequent. 16 …”